Colorectal surgery

If your treatment part of the ERAS programme for
colorectal surgery, please see the ERAS page

What we do

We provide a specialist colorectal service at both Chelsea and Westminster Hospital and West Middlesex University Hospital, looking after patients with all problems affecting the large bowel (colon), small bowel (intestines) and the rectum and anus (bottom).

We offer six outpatient clinics a week in which we see new and follow up patients. We have recently introduced a ‘straight to test’ protocol for suspected colorectal cancer patients. This involves a nurse-led telephone assessment clinic, following which patients attend for their investigations. This innovative approach reduces patient waiting time, and streamlines the patient’s pathway.

Patients with stomas (‘a bag’) are able to see our stoma therapists in their daily outpatient clinics. Our cancer clinical nurse specialists hold four clinics a week helping patients being treated or followed up for colorectal cancer. 

Conditions we treat include:

At West Middlesex, all forms of colorectal surgery are offered within the department. Mr Smith has a specialist interest in Inflammatory Bowel Disease (Crohn's Disease & Ulcerative Colitis) and offers Ileal Pouch Surgery. All consultant surgeons perform laparoscopic (keyhole) surgery for most colorectal disorders. All consultant surgeons also perform the full range of general surgical procedures and manage emergency general surgery and colorectal surgery admissions to the hospital.

Ileoanal J-pouch one-stop clinic

The ileoanal J-pouch clinic is a multidisciplinary service offered to patients who have an ileoanal pouch or are considering having surgery. This one-stop clinic involves an endoscopic assessment of the pouch (pouchoscopy) and same-day meeting with our team of colorectal surgeons, gastroenterologists, IBD and stoma/pouch nurses. Dedicated imaging is also arranged on the same day as required. 

Conditions usually evaluated in the J-pouch clinic include pouchitis, pouch dysfunction, pouch-anal and pouch-vaginal fistulae, increased bowel frequency, primary ileoanal pouch and redo pouch surgery, and surgical treatment of ulcerative colitis. Patients and GPs will be able to link directly to the team to answer queries and arrange appointments and follow-up.

We can receive GP referrals or patients can self-refer by emailing chelwest.j-pouch@nhs.net. A preliminary telephone/virtual appointment is often arranged prior to face-to-face consultation.

The ileoanal pouch service is led by Mr Valerio Celentano (Consultant Colorectal Surgeon) who can be reached on Valerio.celentano@nhs.net.

Complex abdominal wall reconstruction unit

The complex abdominal wall reconstruction and incisional hernia unit specialises in the treatment and care of patients with complex abdominal wall hernias.

The CAWR unit is run with a systematic multidisciplinary approach including specialist surgeons (colorectal, upper GI and plastic surgery) and with expertise from radiology, anaesthetics and bariatric services. This multi-professional approach ensures each patient is afforded expert opinion from medical disciplines that may be beneficial to their care.

Upon referral to the unit each patient is seen individually in clinic. Here they will undergo clinical assessment, be referred for routine blood tests, undergo cross-sectional imaging (CT or MRI) and will undergo medical photography.

All patients are then discussed in the multidisciplinary team (MDT) meeting where individual plans for patients are decided upon to ensure optimal outcomes. This includes preoperative optimisation as well as operative and postoperative planning.  The MDT is now a regional MDT, with colleagues from other units across London and the South East dialling in or attending to discuss their cases, or refer patients.

Established in 2016, the unit is led by Mr Oliver Warren, a specialist in this area who has done over 100 of these complex operations, and has published and presented Chelsea and Westminster Hospital’s results widely.

Features of the unit:

  • specialist imaging and radiology
  • expertise in complex hernia repair including component separation and transversus abdominus release
  • parastomal hernia repair, pernineal hernia repair, plastic reconstruction, abdominoplasty
  • expertise in anaesthetics and pain management
  • botox injection pre-operatively
  • integrated links with pre-operative assessment and intensive care

Clinical research

Clinical research is a vital part of the unit. We pride ourselves on continued efforts to improve standards in this specialist area of surgery and improve outcomes for our patients.

We have already published on optimisation of patients to improve outcomes and quality of life outcomes in our patients. We have shown that MDT working provides a robust management framework and improves outcomes. Our work has been presented internationally and contributed to guidance from the British Hernia Society (BHS). Mr Warren sits on the BHS Complex Abdominal Wall sub-committee.

Current research is focussing on a number of key outcomes for patients including, importantly, continuing to evaluate quality of life measures and outcomes.

Our team

Professor Paris Tekkis is our clinical lead at Chelsea and Westminster and  Mr Jason Smith is the clinical lead at West Middlesex. At Chelsea and Westminster we have four colorectal surgical consultants who look after patients in both emergency and planned (elective) settings and at West Middlesex we have three full time consultant colorectal surgeons, a specialist colorectal nurse and two specialist stoma nurses.

 A specialised pelvic floor dysfunction clinic is provided at Chelsea and Westminster on a weekly basis by one of our consultants Mr Emile Tan, supported by nurse specialists. This is for patients with incontinence, chronic constipation and difficulty opening their bowels. There are a number of operating lists every week in both our main operating theatres and in our treatment centre, where day surgery is carried out. All four consultant surgeons perform at least one endoscopy list per week, in our Diagnostic Centre, on level 2.

Contact information

Chelsea and Westminster Hospital

Our outpatient clinics are located on the Lower Ground Floor of the main hospital site. We perform day surgery in the Treatment Centre on the Ground Floor. The main operating theatres are on the 5th Floor, next to the Intensive Care Unit. Endoscopies are performed in the Diagnostic Centre on the 2nd Floor.

T: 020 3315 6666

West Middlesex University Hospital

The Department of Colorectal Surgery is located in the East Wing of the West Middlesex University Hospital.

T: 020 8321 5972
W: www.westmidcolorectal.org.uk

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